Abstract
Crohn’s disease is characterized by persistent or recurrent chronic inflammation that may affect any segment of the gastrointestinal tract. It has an oscillating evolution, with periods of activity alternating with periods of remission. Crohn’s disease has a significant impact on the economic status due to its increasing prevalence, often affecting young people. Suitable management for these patients involves frequent evaluations. Even though colonoscopy is the gold standard for the assessment of severity and mucosal healing, it is an invasive maneuver, not easily accepted by patients, and it does not have good repeatability. Intestinal ultrasound has the advantage of being non-irradiating, non-invasive, well-tolerated, cheap, and easy to repeat. Ultrasound parameters such as bowel wall thickness, intestinal wall architecture, intramural vascularisation, proliferation of mesenteric fatty conjunctive tissue, and intraperitoneal fluid can provide good information regarding the severity of the disease, the differentiation between remission and relapse, and its complications. Some of the latest studies show good correlations between ultrasound parameters and inflammation markers (C-reactive protein, fecal calprotectin) and clinical severity scores of Crohn’s disease. Consequently, the importance of intestinal ultrasound has increased lately, and recent studies support its use to evaluate the severity of inflammation, differentiate between active disease and relapse, monitor therapy response and guide treatment, evaluate prognosis, and diagnose complications.
Highlights
Inflammatory bowel diseases are chronic immune-mediated inflammatory disorders of the gastrointestinal tract, characterized by an oscillating evolution, with periods of activity alternating with periods of remission
Crohn’s disease is characterized by a persistent or recurrent chronic inflammation, diffuse or occasionally granulomatous, that may affect any segment of the gastrointestinal tract, mainly localized at the level of the terminal ileum
The abdominal ultrasound is helpful in diagnosing an important variety of gastrointestinal disorders
Summary
Inflammatory bowel diseases are chronic immune-mediated inflammatory disorders of the gastrointestinal tract, characterized by an oscillating evolution, with periods of activity alternating with periods of remission. Their etiopathogenesis is unknown, the pathogenic immune substrate interfering with the microbiome and the environmental factors in people with a genetic predisposition. The inflammation is divided into segments, alternating with healthy asymmetrical and transmural mucous areas (the classical “paving stone” aspect). Complications such as stenosis, abscesses, or intestinal or perianal fistulas may occur during evolution. The positive diagnosis is reached by gathering the clinical, laboratory data, the colonoscopy, and histologic aspects
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